Type 2 diabetes is a major drain on resourcesBMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7237.732 (Published 18 March 2000) Cite this as: BMJ 2000;320:732
Type 2 diabetes costs Britain's NHS £2bn ($3.2bn) a year—4.7 of total NHS expenditure—and an additional £36m is spent on related social services and private health costs, claims a new report published this week.
This high cost is caused largely by the treatment of complications of the disease, as they increase the overall NHS spending for an affected patient more than fivefold.
The study, published in the TARDIS report, was conducted jointly by the British Diabetic Association, the King's Fund, the Economists Advisory Group, and SmithKline Beecham Pharmaceuticals UK.
The report builds on the findings of the UK prospective diabetes study (UKPDS), which called for tight blood pressure control for these patients (BMJ 1998;317:703-13). The authors claim that “millions of pounds could be saved from NHS budgets” by preventing the complications that accompany the disease.
The investigators set out to provide a basis for future allocation of health and social service resources by measuring the economic and quality of life impact of the disease on patients and their carers. Their data were collected in spring 1999 by a postal survey of 1578 people with type 2 diabetes and their carers, living in four areas of England and Scotland.
“We found that people with the disease are two to three times more likely to be admitted to hospital than their demographic peers and that they stay an average of four times as long. People who also had complications were five times more likely to enter hospital than were peers who had diabetes alone,” said Dr Steve Gillam, director of the primary care programme at the King's Fund (a healthcare think tank) and one of the authors of the report. One finding is that 42%of overall expenditure is on inpatient care.
The data also show that the presence of both microvascular and macrovascular complications increases social services costs fourfold and personal expenditure threefold; it also doubles the need for carers.
“The results confirm that type 2 diabetes is a serious disease with far reaching implications. Investment in the prevention of complications rather than their treatment is the key to improving patients' lives and reducing the NHS burden,” said the chairman of the study group, Professor Rhys Williams, professor of epidemiology and public health at the University of Leeds.
He called for the government to invest in methods that will prevent complications, for the national service framework to promote measures that reduce the risk of complications, and for the increased and earlier use of new and more effective interventions.
An abstract of TARDIS: Type 2 Diabetes Accounting for a Major Resource Demand in Society in the UK is available from Julia Bottomley of SmithKline Beecham (tel: 020 8913 4000).